Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.20 / $27.91 / $105.26	Facility		$17.20	$27.91	$105.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.20 / $28.65 / $92.98	Professional		$17.20	$28.65	$92.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $67.31 / $447.45 / $447.45	Professional	50	$67.31	$447.45	$447.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.40 / $39.69 / $107.70	Professional		$25.40	$39.69	$107.70
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.11 / $59.53 / $161.56	Professional	50	$38.11	$59.53	$161.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.55 / $20.32 / $39.69	Facility		$16.55	$20.32	$39.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.91 / $27.21 / $35.97	Professional		$25.91	$27.21	$35.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.79 / $87.40 / $134.08	Facility		$74.79	$87.40	$134.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.10 / $69.17 / $129.65	Professional		$31.10	$69.17	$129.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $17.27 / $32.65 / $59.17	Facility		$17.27	$32.65	$59.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.23 / $36.70 / $1,449.00	Facility		$19.23	$36.70	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.34 / $72.23 / $210.88	Professional		$33.34	$72.23	$210.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.97 / $65.00 / $96.85	Professional		$34.97	$65.00	$96.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $17.27 / $32.65 / $59.17	Facility		$17.27	$32.65	$59.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $61.48 / $95.56	Professional		$39.65	$61.48	$95.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $28.58 / $28.58 / $78.72	Facility		$28.58	$28.58	$78.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $37.67 / $120.11 / $210.88	Professional		$37.67	$120.11	$210.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $53.75 / $110.10 / $181.61	Professional		$53.75	$110.10	$181.61
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $31.26 / $63.76 / $127.23	Professional		$31.26	$63.76	$127.23